Aug 28, 2015 | By Alec
Medical applications of 3D printing technology seem to be bursting into hospitals everywhere to save lives and deal with complex situations. While some biomedical applications have been succesful, most of these are relatively simple: 3D print an exact replica of the problem area to carefully prepare surgery and increase success rates. What’s more, a surprising number of these solutions seem to take place in China, where neurosurgeons in the Fujian Medical University are even applying this concept to very complex brain surgeries to deal with intracranial aneurysm patients. Since 2014, they have dealt with about 10 patients this way, recently tackling another.
The tenth patient was the fifty-year-old Li Yimu, from Quanzhou, China. Almost overnight, she suddenly began suffering from extreme headaches – up to the point that it was described as ‘about to explode’ – as well as nausea, vomiting and more. Her family sent her to the hospital, where doctors discovered subarachnoid hemorrhaging in her brain. Further CTA examinations revealed that Li Yimu had 4 different sizes of intracranial aneurysms with a diameter of 7-15 mm, the largest being the size of a peanut (and a small one being slightly smaller than a green bean). This is severeal times larger than a number blood vessel, which is only about 2-3 mm in diameter.
As the neurosurgery professor Kang Dezhi, who is also the Executive Vice President of the hospital, explained, that’s a very serious condition. Brain aneurysm is one very important cause of subarachnoid hemorrhage, but not the same as a tumor. Instead, it blocks blood flow and forms intracranial tumor-like protrusions. As these blood vessels are hardly elastic, they are typically described as bombs ready to explode. ‘A lot of patients feel very good and don’t suffer from symptoms in one moment, and once the explosion of intracranial aneurysms happens their lives are in danger in the next,’ he said.
In this particular case, one of Li Yimu's aneurysm ruptured, but more lethal is that the largest intracranial aneurysm was located close to the brain stem--the life center of the brain. Once exploded, doctors can do very little and therefore ‘bomb disposal missions’ are crucial. ‘Once an intracranial aneurysm is found, you can't wait until the 'explosion' and then go to find treatment, it is better to have an early surgical treatment,’ he said. Prevention is the best option. Patients with high blood pressure, diabetes, high cholesterol, or have a family history of cerebral aneurysms are all in the high-risk group and are advised to regularly get check-ups. A single CT scan will do. Especially in danger are middle-aged people above the age of 40, during periods of emotional distress, during exercise, while coughing or defecating. A few other factors can also contribute to a rupture, and symptoms include unexplained headache, dizziness, diplopia and pain in the eye.
Fortunately for Li Yimu, professor Kang Dezhi and his team have been using 3D printing technology as an innovative diagnostic tool for the treatment of aneurysms since October 2014. Up to the present day, they have successfully used it on ten separate occasions. This is particularly useful in the brain, which is the most sophisticated organ in our body, featuring a very complex vascular and neural structure that is very very fragile. As the professor explained, the minimally invasive surgical openings also extremely limit the capacity for doctors to reach and work with the aneurysms – for each they have to cross a huge maze of nerves and blood vessels.
That’s why 3D printing offers a fantastic alternative to scrambling your brain. Using CT scan data, they develop a 3D model and 3D print it in resin materials featuring different levels of hardness. The result is a high simulation aneurysm model, including skull, blood vessels and aneurysms. According to the professor, they made a 1:1 scale 3D printed model, in which all the arteries and structures and aneurysms are all very accurately copied and visible. Perfect for practicing the surgery before the operation. They can determine which sized-tools and clamps are perfect for each specific case and discover the best routes for navigating through a patient’s brain.
As you can expect, such a 3D printed model greatly improves the chances of surgical success, but does more than that. ‘In addition, the model can also be used for clinical teaching, surgical training, surgical conversation before the operation and morphological study of the aneurysm surgery and so on, Professor Kang added.
In this particular case with Li Yimu, professor Kang Dezhi and his team decided on two separate ‘bomb disposal’ surgeries, due to the specific distribution of the aneurysms. The first surgery focused on the right side of her head, where they made two 2.5-3 cm bone windows and took out three brain aneurysms. Taking 4 hours, the operation was a success. After 17 days, doctors again made a 3cm window on the right side of her skull, and spent another hour dismantling the last of the bomb threats. According to the latest reports, Li Yimu is doing well and was discharged from hospital after rehabilitating for a week.
Posted in 3D Printing Applications
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